MAPAS POP111 Tutorial #8: Lectures 22-24

Flashcards covering lectures 22-24, including Māori health, health promotion, disease prevention, and screening initiatives.

Māori Health: The State of Māori Health

Systemic inequities in health outcomes, exposure to determinants of health, health system responsiveness, and representation in the health workforce. Ethnic inequities can be eliminated and prevented.

What Causes Health Inequities?

Health inequities are fundamentally driven by the unfair distribution of health risks and opportunities (social determinants of health).

Ottawa Charter Pre-requisites

Peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice and equity.

Ottawa Charter Primary Action Areas

1. Build healthy public policy. 2. Create supportive environments. 3. Strengthen community actions. 4. Develop personal skills. 5. Reorient health service.

Māori Health Promotion Definition

The process of enabling Māori to increase control over the determinants of health and strengthen their identity as Māori, thus improving their health and position in society. Allowing self-determination.

Mauriora

Access to Te Ao Māori (not just mono-cultural).

Waiora

Environmental protection. Health is tied to a healthy environment - kai collection and making.

Toiora

Healthy lifestyles - what people are most focused on.

Te Oranga

Participation in society - housing and neighborhoods.

Ngā Manukura

Health professional AND community leadership.

Te Mana Whakahaere

Capacity for self-governance. Community control and enabling political environment.

The SIDS Story - Why the Fail?

Did not accommodate to Māori cultural norms.

Te Pae Mahutonga & the SIDS Story - Mauriora

Working with communities to incorporate/revitalize traditional practices. Wahakura.

Te Pae Mahutonga & the SIDS Story - Waiora

Promoting smoke-free spaces and safe bed sharing.

Te Pae Mahutonga & the SIDS Story - Toiora

Smoking cessation programmes and breastfeeding promotion.

Te Pae Mahutonga & the SIDS Story - Te Oranga

Advocacy to improve education and income support.

Te Pae Mahutonga & the SIDS Story - Ngā Manukura

Māori professional and academic leadership; collaboration with community leaders.

Te Pae Mahutonga & the SIDS Story - Te Mana Whakahaere

Communities are enabled to identify their own aspirations and priorities, and to lead the design of their own solutions.

Population-Based (Mass) Strategy

Focus on the whole population, aiming to reduce the health risks/improve the outcome of all individuals in a population

High Risk (Individual) Strategy

Focuses on individuals who are perceived to be high risk; trying to move people at the high-risk end of the curve toward the more favorable distribution

Health Promotion

Helping people to change their lifestyle to be more healthy, facilitated through increased awareness, behavior change, and creating environments which support good health practices

Disease Prevention

Disease-focused domain, looks at particular diseases & ways of preventing them, relates to primary, secondary, or tertiary disease prevention strategies

Health Protection

Environmental hazard focused - Risk/hazard assessment (safe air and water, biosecurity), Occupational health and monitoring, Risk communication

Screening in Health

Applying a screening test on a relatively large population to Identify exposure to disease risks, unrecognized disease & complication of a disease + Intervention/treatment

Criteria For Screening : Suitable Disease

Important public health problem, early detection & intervention leads to better outcomes, relationship of risk factors known, increased duration of pre-clinical phase

Criteria For Screening : Suitable Test

Reliable, safe and simple, affordable, acceptable, accurate

Criteria For Screening : Suitable Treatment

Evidence of early treatment leading to better outcomes, effective, acceptable and accessible treatment; benefits need to outweigh any potential harm

Criteria For Screening : Suitable Screening Programme

RCT evidence that it will reduce mortality and increased survival time, adequate resourcing and agreed policy for testing, cost-effective, reach all those who are likely to benefit

Lead Time Bias

An apparent increase in life expectancy when really the person still dies at the same time because a disease was detected earlier by screening than by diagnosis

Length Time Bias

Screening is more likely to detect slower-presenting diseases leading to an overestimation of survival duration to an excess of slower progressing cases.

Sensitivity

The likelihood of a positive test in those with the disease

Specificity

The likelihood of a negative test in those without the disease

Positive Predictive Value (PPV)

The proportion who really have the disease of all people who test positive; the probability of having a disease if the test is positive

Negative Predictive Value (NPV)

The proportion who are actually free of the disease of all people who test negative; the probability of not having a disease if the test is negative